| NPI | 1831396357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NJ MA092542) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD447907) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2021-05-27 |